Geriatric Oncology Screening of Older Patients With Solid Cancers

Summary

Older patients with cancer constitute a heterogeneous group with varying comorbidity; therefore, geriatric assessment with initial screening is recommended. The Geriatric 8 (G8) has been established as a promising screening tool. Currently, there are no guidelines for oncogeriatric screening in older cancer patients in Denmark. We hypothesize that by screening persons age 70 years or more with newly diagnosed cancer, with the G8, we can assess the prognostic value and identify a subgroup of patients who will benefit from a CGA.

Aims:

* Determine whether Danish cancer patients, with a G8 score of ≤14, experience poorer quality of life (QoL), receive less recommended standard cancer treatment, experience more treatment-related toxicity, stop treatment earlier, and experience shorter survival than patients with a G8 score \>14.
* Ascertain whether the standard G8 cut-off score of ≤14 is the most relevant cut-off score, with respect to treatment adherence, treatment-related toxicity, QoL, and survival, when focusing on the older Danish cancer patient population.
* Establish whether the performance and prognostic value of the G8 can be strengthened through the addition of a functional measure, the 30-second chair stand test (30-CST), and/ or the handgrip strength test (HGST).
* Evaluate the prognostic value of the modified Geriatric 8 (mG8)

Methods:

A prospective, descriptive study of all outpatients with newly diagnosed solid tumors at the Department of Oncology, Odense University Hospital, age 70 years or more. Patients will be screened with the G8, mG8, 30-CST, HGST, and QoL questionnaires at baseline with subsequent one-year follow-up, to determine the prognostic value of the G8 and the mG8. An initial two-month pilot study will help determine inclusion rates and highlight necessary practical adjustments to ensure optimal study participation. Baseline characteristics will be compared with descriptive statistics. Our primary endpoint; Global Health status/ QoL (EORTC QLQ-C30 \& QLQ-ELD14), and secondary endpoints; treatment adherence, and treatment-related toxicity, will be assessed using logistical regression; while secondary endpoints; overall survival, cancer-specific survival, will be assessed using the Kaplan Meier analysis and Cox proportional hazard models. Post hoc diagnostic performance analysis will be conducted to determine the optimal G8 cut-off and whether functional measures (30-CST and HGST) can enhance screening accuracy.

Conditions

• Solid Carcinoma
• Frailty
• Age
• Geriatrics
• Screening
• Cancer

Interventions

DIAGNOSTIC_TEST

Geriatric 8

The G8 is an eight-item screening tool, developed for older cancer patients. The G8 score ranges from 0 (heavily impaired) to 17 (not at all impaired), with a cut-off for potential frailty of ≤14.

DIAGNOSTIC_TEST

modified Geriatric 8

The mG8 is a modified version of the Geriatric 8 screening tool, consisting of 6-items. The mG8 score ranges from 0 (not at all impaired) to 35 (heavily impaired), with a cut-off for potential frailty at ≥6.

DIAGNOSTIC_TEST

30 second chair stand test

Repetitions within 30 seconds

DIAGNOSTIC_TEST

Handgrip Strength Test

Measured in kilograms

Sponsors & Collaborators

• Academy of Geriatric Cancer Research

  collaborator UNKNOWN

• Danish Cancer Society

  collaborator OTHER

• University of Southern Denmark

  collaborator OTHER

• Odense University Hospital

  lead OTHER

Principal Investigators

• Marianne Ewertz, MD, DMSc · University of Southern Denmark

• Jesper Ryg, MD, PhD · Department of Geriatric Medicin, Odense University Hospital

• Cecilia M Lund, MD, PhD · Department of Clinical Medicin, Herlev and Gentofte Hospital

• Trine L Jørgensen, MD, PhD · Department of Oncology, Odense University Hospital

• Per Pfieffer, MD, PhD · Department of Oncology, Odense University Hospital

• Henrik J Ditzel, MD, DMSc · Department of Oncology, Odense University Hospital

Eligibility

Min Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-06-03

Primary Completion

2022-11-15

Completion

2022-11-15

Countries

• Denmark

Study Locations